Surgical Oncology Flashcards
what is a pre-treatment biopsy?
an incisional biopsy
what is an example of an incisional biopsy ?
needle core, wedge or punch biopsy
what is a post-treatment biopsy?
an excisional biopsy
what is an excisional biospy?
removing the tumor then sending for histopath
what should you do before you do a biopsy or mass removal?
document the size, location and movability of the tumor
when should we elect to do a pretreatment biopsy?
- if we suspect a false negative
- there is a life or death decision being based on the FNA results
- the tumor grade will change your surgical approach
- owners willingness to treat would be changed
is it ever wrong to take a pretreatment biopsy?
NO
what is something we need to consider when doing an incisional biopsy?
the orientation of incision, orient along the lines of tension
when do we NOT use a punch biopsy?
hypodermal masses because tissue can shift an undetected hemorrhage can occur
when do we use a wedge biopsy?
for ulcerated or necrotic tumors or a deeply located mass
what instrument can we use to maintain tissue retraction for deep tumors?
gelpi retractors
when should we do an excisional biopsy ?
- when treatment would NOT be altered by tumor type or grade
- procedure to get mass is invasive (ex. splenectomy)
- location allows wide margins without compromising potential for future re-excision
what do we need to consider when doing an excisional biopsy?
to prevent tumor seeding in the surrounding tissue
what are the types of excisions in the Enneking system ?
- intralesional
- marginal
- wide
- radical
what is an intralesional excision?
debulking by cutting into the tumor and psuedocapsule
